P4H - 13th July 2016 Birmingham NEC

I shall be presenting the Supplier Training Zone at P4H, the leading Procurement event supporting Operational productivity in the NHS run by BIP Solutions.  Which is a bit of a mouthful, but does describe what it is about.

It is free to the Public Sector, and £95 for private sector - but hopefully the training sessions alone compensate for that (not necessarily mine, of course - there are 3 other training zones as well).  The sessions I am running are not only applicable to the NHS, so there would be value in popping along if you supply other Public sector bodies too.

Hope to see you there.

NHS Pricing on labels

Jeremy Hunt, the health secretary, is leading an initiative to put indicative prices on all NHS medicines over £20.  Though I have been negative about some government initiatives, this is one I support - though before you swoon in surprise I have to point out that I think the strapline "paid for by the taxpayer" is cheesy and unnecessary.  (I am though quite in favour of the proposal of a chap on BBC Question Time that MPs should have to wear the same line on a badge on their suits - but maybe it doesn't go far enough and we should insist they all wear HM Parliament boiler suits branded with that as a logo.  But I digress)

People are very unaware of the costs of the NHS.  A prescription costs £8.20.  I am not sure how much of that is actually administration costs (and I cannot find it - perhaps you know?) but given that a private prescription from a doctor may cost £15, and according to CIPS a Purchase Order typically costs £50, I believe that in fact ALL that charge is administration cost (and probably does not cover all of those costs).  So we literally do not pay for the pharmaceutical at all - just contribute to the administration of the process.

Which of course leads to the usual complaints that is is cheaper to buy Asprin over the counter than to get it through prescription.  People do not realise what they are actually paying for.

Let's do some back of a fag packet assessments.  (now that few people smoke, what can we use instead of fag packets?  Just asking)

Nearly 20 years ago my wife was taken ill in the USA.  Though we had medical insurance the bills we received (and had to pay before claiming back the money) where a real eye-opener.  The initial 5 minute consultation with a doctor was $50 - he said "go to hospital".  Kerching.  We went to hospital, where my wife had a 5 minute consultation ($150), and got a prescription for antibiotics, which cost us $80 at a nearby pharmacy.  Total cost $280 plus a bit of driving around.

Recently my son broke his ankle here in the UK.  A NHS doctor's consultation (she said "go to hospital"), a 5 minute consultation with a nurse, an x-ray, 5 minutes with a doctor, plaster clinic, and loan of crutches cost us £2.50 in car parking fees.  Subsequent new rubber ferrules for the crutches, x-ray, removal of cast, 5 minutes consultation with doctor cost us a further £2.50 in car parking fees.  A total of £5 and a bit of driving.

Looking on the internet the cost to the NHS might be £4 for the ferrules alone.  (Ferrules was a new word for me, so I am getting maximum mileage from it)  Based on salary cost of £50/hour that is £25 of staff time at minimum.  We haven't even considered overheads, infrastructure etc.

Based on my US experience I would expect that the cost might have been say twice what we paid 20 years ago, so $560 or £350.  According to this website that might be the lower end of a range that could run from $520 to $1000, or even $2500.


If you get something free you tend not to value it, but to take it for granted.  The NHS is free at the point of use, which is great because I did not need to consider the cost or call my insurance before taking my son to the doctor.  However I then did not actually value the service accordingly.

Incidentally my kids were born by emergency Caesarian section back in 2002.  The average bill for that in the USA according to a 2011 study by Truven Health Analytics was $50 000.  For that operation, and a month in Intensive Care Baby unit we paid just some car parking fees.   I call that a bargain.  How much of a bargain, I only realised by doing some research.

If I had been presented with an indicative bill for that service, then perhaps it would put the complaining about the price of parking into a bit of perspective.

The illustration incidentally is for a US bill for treating a snake bite.  Ouch and ouch again.

Business Basics: Looking after your health

The Head of Lloyds TSB, Antonio Horta-Osorio, is taking medical leave after suffering from physical and mental exhaustion.  There has been speculation about whether he will ever return, but thankfully relatively little suggestion that his illness showed that he was not up to the job.

There is a common machismo in business that can easily lead people to overwork without taking care of themselves.  It is an easy trap.  Office life is pretty sedantary, commuting is both stressful and sedentary, and much business life revolves around either lunches or fast food grabbed on the run.  It is easy to put on weight and take no exercise.  And to cap it all wine or beer often accompanies the lunch or dinner, or is an easy way to relax after a stressful day with the boss, co-workers or customers.  Holidays are distractions from the office, and thanks to blackberries and the internet often not even that much of a break.

I'm not being moralistic, and my wife will point out that I am guilty of much of the above.   Especially not taking at holidays and working at weekends.  My self justification is that my income depends on the level of work I do, and so a holiday costs double in both the cost of the holiday itself and lost income.

This cuts little ice.

And rightly so.  What we often dont think about it that if we do not take breaks, eat and drink moderately, and excercise well it actually interferes with our ability to do the job.  Maybe not in the short term, but for most people the working career is long.  And getting longer.  We can now expect to be at the coalface for 45 years or more.  That is a marathan not a sprint.

When we are stressed and have poor health we tend to make poor decisions.  We tend to be depressed and morose, or occassionally manic, and our judgement goes.  Of course we don't notice it.  But it happens.
And we are no use to the business if we have a heart attack (or worse).

Exhaustion is easy to fall into.  Your body and brain just pack up with the stress and exertion.  Some people come back more aware and able to prevent it in future.  Others never come back.
  So no matter the workload and the crisis, try to put some effort into looking after yourself.  Athletes train and watch their food to ensure they perform at the top level.  Business people need to do a bit of the same.  Only a bit - today I have just had a delicious bacon butty, but I did go to the gym.  I found that setting gym visits as a KPI helps me to go regularly - otherwise it is just something I intend to do but don't get round to.  I might not make my 100 gym trips per year, but recording how many I have done (and how many still to go) helps me focus.  For you it might just be scheduling a daily 10 minute lunchtime walk to the coffee shop.  My today list has a little section for personal development which includes going to the gym.

Your doctor probably gives you all the advice you need on this (mine has wanted me to lose 10kg for 20 years), and I don't to be another nag.  Just that you need to think about and prioritise your health to ensure you can work at peak performance for nearly half a century.  The usual suspects - watch what you eat, stop smoking, try not to drink too much, take regular holidays (ideally somewhere with no Blackberry reception - I recommend the Scottish Borders!), walk or take regular exercise.  You are no use to anyone if you are dead.

And incidentally the same applies to your staff and direct reports.